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Ask Dr. A.S. Desai Your Own Question
Dr. A.S. Desai
Dr. A.S. Desai, Ophthalmologist
Category: Eye
Satisfied Customers: 2405
Experience:  MS Ophthalmology with 13 years of surgical expereince
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What would cause a persons lt eyelid to droop and worsen when

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What would cause a persons lt eyelid to droop and worsen when they are tired. Also when I smile the lt side of my mouth droops some.
Thank you

Dr. A.S. Desai :

Hello, Thank you for the question.I am Dr.A.S.Desai and I look forward to assisting you .

Dr. A.S. Desai :

Are you available for chat now?

Dr. A.S. Desai :

Actually the muscle that lifts the eyelid or helps to keep the eye open and the muscle which helps the angle of the mouth to rise when we smile are supplied by the same nerve which is the seventh cranial nerve ( facial nerve). Thus a drooping of the eyelid and the angle of the mouth on the same side does appear to be due to a partial weakness of the seventh cranial nerve. When there is a weakness or paresis, there may not be all the signs of Bell's palsy . This could be reason why you may not be having all the signs of it.

Dr. A.S. Desai :

Seventh nerve paresis could be due to diabetes, hypertension, ear infection,idiopathic ( when the exact cause is not known), autoimmune disorders and other less common conditions. Idiopathic facial paresis could be due to a viral infection of the facila nerve and is usually self ,limiting with complaete recovery within 6 weeks to 6 months.

Dr. A.S. Desai :

I am sorry for a small mistake in my typing. Kindly let me clarify it. It is likely that the normal eye is drooping while the other eye is lagophthalmic due to facial paresis. " Actually the muscle that lifts the eyelid or helps to keep the eye open and the muscle which helps the angle of the mouth to rise when we smile are supplied by the same nerve which is the seventh cranial nerve ( facial nerve)." It should have been the muscle that helps to shut the eye and the muscle which helps to close the lips or purse the lips are supplied by the seventh nerve.There is a possibility that there is weakness of the right side of the face ( the right eyelid is unable to close completely which makes the left lid appear droopy).In facial paresis , on attempting to smile, on the affected side , the angle of the mouth does not move making the other side of the mouth appear to move ( this could give the appearance of a droop in the left side of the mouth).

Dr. A.S. Desai :

I guess I would agree with the doctor who thought it could be Bell's palsy .It is likely to improve in a few weeks time naturally. It is better to use lubricating eye drops to keep the cornea moist and avoid dryness ( especially the right eye). However it may not be needed if the right eye shuts completely.

Dr. A.S. Desai :

Please let me know if you have any more queries in this regard. I look forward to you reply.

Dr. A.S. Desai :

If you need more help, please use the reply tab to continue our conversation. If you do not require further assistance, kindly rate my service.



Thank you and best wishes.



It was a pleasure to have answered this question.

Views expressed are for information purpose only and cannot substitute a visit to an ophthalmologist

Customer: The rt side of my face is normal. I've had the problem with the lt eye drooping for at least 2years; however, it is getting so it droops more.
Dr. A.S. Desai :

I can see that you have entered the chat. My screen shows that you are typing.... I sorry about the initial error :(

Dr. A.S. Desai :

Have you been examined by an eye doctor? Drooping of the euelid is called ptosis and is again due to weakness of a different muscle ( levator muscle which lifts the eyelid up).

Dr. A.S. Desai :

eyelid

Dr. A.S. Desai :

Two years is a long time for drooping of the eyelid.

Dr. A.S. Desai :

Ptosis can occur due to nerve paralysis ( third cranial nerve), muscle weakness as in myasthenia gravis or aponeurotic which is age related , mechanical( due to any mass lesion of the upperlid).

Customer: I'm waiting for my appointment which which is still 2months away. It is to the point now that at times it actually interferes with my vision because it is drooping so bad.
Dr. A.S. Desai :

Are you there?

Customer: Yes look just above that last entry of yours.
Dr. A.S. Desai :

It is likely to be aponeurotic ptosis since it is involving one eye only . It is unlikely to be due to myasthenia gravis which is bilateral whereas third nerve palsy would have caused other symptoms such as double vision and deviation of the eye. Aponeurotic ptosis can be corrected with eyelid surgery.

Customer: Thank you
Dr. A.S. Desai :

You are most welcome.

Dr. A.S. Desai :

Is there anything else that I can answer for you?

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